Developing a systems thinking guide for enhancing knowledge mobilisation in prevention research July 2023, Volume 33, Issue 2

Background

Public health research provides much of the evidence base for public health policy planning and implementing interventions to improve population health and quality of life. Our understanding of how research knowledge is incorporated into public health policy and practice has been evolving over the decades and is subject to an ongoing debate.^1-5 Increasing attention is being given to the complexity of policy processes and contexts that influence research uptake. These include the influence of competing policy needs, stakeholder interests, political perspectives, interest groups, and shifts in the economic climate and political priorities.⁶ Researchers need to understand and consider these complex factors when developing strategies to best support the uptake of their research. One way of addressing and negotiating this complexity of factors is to consider the engagement with, and use of, research and evidence as a process of knowledge mobilisation.

Knowledge mobilisation aims to increase the overall impact of research by making research accessible, by creating social interactions through purposeful connections between researchers and end users, and facilitating deliberative dialogue that can increase mutual understanding and improve the relevance and applicability of research. This, in turn, maximises the impact of the research through an increased likelihood it will be used in public policy and professional practice. Knowledge mobilisation, by its nature, has a systems thinking orientation because of its focus on iterative, emergent and collaborative processes.^1,7 This takes it beyond linear translation and dissemination approaches and two-way processes such as knowledge exchange.⁸ It is, perhaps, most similar to the concept of integrated knowledge translation.⁹ A systems thinking approach views the world as complex systems of dynamic, interdependent parts that are often linked by a common purpose.¹⁰ Systems thinking can be used to understand the complex multifactorial drivers that influence health and ‘wicked’ problems such as growing rates of chronic disease.¹¹ It can also guide strategies for mobilising research knowledge for policy and practice.¹⁰

Previously, Haynes et al.¹⁰ analysed the literature at the intersection of systems thinking and knowledge mobilisation, framed by a) applied knowledge mobilisation archetypes developed by Huw Davies et al.⁵ , and b) levers for enacting change within a system.¹⁰ In this review Haynes et al. proposed a “range of considerations that may be useful when planning, developing and implementing knowledge mobilisation activities for complex problems” and generated more than 100 recommendations for undertaking knowledge mobilisation using a systems thinking approach. Our paper reports on a practical ‘systems thinking guide for knowledge mobilisation’ – a tool developed by distilling the work by Haynes et al. and piloted as part of the ongoing work of the Australian Prevention Partnership Centre (Prevention Centre) (Box 1). This guide aims to inform and support prevention researchers seeking to incorporate systems thinking into their research planning and development to improve knowledge mobilisation and, thus, the impact of their research.

Developing a systems thinking guide for knowledge mobilisation

We undertook a process of distilling the core elements of the table of recommendations by Haynes et al. for undertaking knowledge mobilisation using a systems approach (see Figure 1 for our methods). This was completed using a combination of thematic synthesis and expert deliberation at a workshop conducted with three authors of that paper (AH, MI and LR) and further analysis and iteration with the authorship team. AH contributed her skills and experience as a qualitative researcher and as the first author of the original paper that this guide synthesised. MI, an experienced mixed-methods researcher, conceptualised the project and arranged and facilitated the workshop and iterations. LR brought her 30 years of experience mobilising knowledge for public health policy and practice to the deliberation and synthesis process. MP and EH drew on their expertise in systems thinking and the policy environment to guide the iteration of the completed guide.

Figure 1:     Flow chart of methods for qualitative distillation of recommendations by Haynes et al. for systems thinking for knowledge mobilisation of research (click figure to enlarge)

This work was informed by the Prevention Centre’s need for a practical systems thinking guide that could be readily implemented in research teams’ knowledge mobilisation practices. At the workshop, the three authors independently analysed the more than 100 recommendations to group them into major themes and subthemes. Using an iterative process of deliberation, each author’s analysis was discussed in relation to their own experiences with knowledge mobilisation and systems thinking¹³, and the themes and subthemes were compared and developed further until consensus was reached. This involved trade-offs – less critical or more peripheral recommendations were discarded in favour of core concepts that had the most resonance for the work of the Prevention Centre. The themes were then grouped according to their relationships to levers for changing a system and finally rechecked for authenticity and alignment with the original work of Haynes et al.¹⁰

Next, the themes were developed into a set of questions designed for the reader to reflect on their research and how they might think about mobilisation of the knowledge derived from their research. MI further refined these questions with expert advice given by the authorship team and trialled them as a pilot with two separate research teams. In these sessions, the research teams discussed the draft systems thinking guide and developed answers to the questions based on their experiences with their ongoing research projects. Their discussions and responses were analysed to determine which questions needed to be further refined for clarity and ease of use.

The final systems thinking guide for knowledge mobilisation includes 13 questions and 18 subquestions. The 13 questions are divided into four categories with the levers for changing the system grouped into the following structure: 1) Goals, structure and rules, and feedback of the target system – including describing the system, mapping the system and the goals for changing the system; 2) Paradigms and core beliefs of the system – including understanding the system through reflection on system goals and core assumptions; 3) Relationships and power in the system – including determining key stakeholders and how to work with key stakeholders for improved outcomes; 4) Actors, elements, practices and resources of the system – including determining capacity, structures and resources that exist and need to be leveraged or need to be created. (Table 1).

Table 1.     Systems thinking guide for knowledge mobilisation

Discussion and implications

Although designed to support researchers to apply the principles of systems thinking to improve their knowledge mobilisation practices and ultimately the impact of their work, this guide could also be used when intervening in a system, for example by policy practitioners. This tool is designed to explore and promote knowledge mobilisation through a targeted approach of understanding the system influences and working more deeply with stakeholders and decision makers, so it could also be valuable for developing research-practice partnerships. Many researchers have noted the importance of using systems thinking approaches to address complexity and support evidence-informed policy and practice in public health and prevention.^14,15This guide is one example of a practical way of fostering this process for knowledge mobilisation. The guide is intended to be used iteratively, and users can focus on sections and questions best suited to their needs.

Users of the guide are encouraged to reflect on the questions in the guide against the backdrop of the system within which they work. The guide invites consideration of the intended role of their research or project within that system. The goal is to develop a ‘mindset’ for taking a systems approach to knowledge mobilisation to inform current and future work to mobilise the knowledge emerging from their research effectively. This guide will provide a structure for the research or project planning process that analyses the system structure of the area of interest. The guide can be used to plan how best to make changes within the system to achieve the desired outcome, for example through effective stakeholder analysis and targeted networks within the system and ensuring capacity and resources are appropriate for the process.

Conclusion

Systems thinking can guide knowledge mobilisation by providing insights into the complexity of processes and contexts and inform strategies to address that complexity. The systems thinking guide for knowledge mobilisation is a practical tool to support this goal. We invite feedback from researchers and policy experts for further inclusions, adaptations or revisions to the guide.

Acknowledgements

MI, MP, EH and LR’s employment is supported through a partnership grant (ID:GNT9100003) from NHMRC with the Australian Government Department of Health, ACT Health, Cancer Council Australia, NSW Ministry of Health, Wellbeing SA, Tasmanian Department of Health, and VicHealth.

Peer review and provenance

Externally peer reviewed, not commissioned.

Copyright:

© 2022 Irving et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.